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How to Apply for a Medical Aid in South Africa


In light of the current inadequacies in the state-funded healthcare system, the number of people turning to the private sector for their treatment has continued to grow. In practice, the bulk of those seeking private treatment could not afford to do so without some financial assistance. To qualify for help, they need to apply for a medical aid membership with one of the schemes in South Africa. So, what must one do in order to become a member of a scheme?

In many cases, for those who are in full-time employment, an employer will have arranged for a group scheme with a particular fund to provide cover for his or her staff. For the self-employed and others with no access to a group scheme, there are between 20 and 30 open schemes from which they can choose. In either case, to apply for a medical aid in South Africa requires one to provide a few personal details and some evidence to support them.

Though not as strict as an application for short- or long-term insurance, a scheme also needs to determine the extent of the risk a member may represent in terms of claim payments. Proof of age and identity must accompany the application form along with proof of membership of another scheme prior to the current application, if applicable. The latter can be important when you apply for a medical aid in South Africa, as it can determine whether you will be eligible for immediate cover or subject to the standard three-month waiting period for first-time members.

You will also need to inform a scheme of any pre-existing condition you may have and be prepared to fund any relevant treatment yourself for the first year of your membership. All other contingencies will be covered, subject to the three-month waiting period, if applicable. Naturally, when you apply for a medical aid in South Africa, you will also be required to provide the same details and documentary proof for any eligible dependents you may wish to be included in your membership.